Case Report: Detection and quantification of tumor cells in peripheral blood and ascitic fluid from a metastatic esophageal cancer patient using the CellSearch® technology

Abstract

Analysis of ascitic fluid should help to identify and characterize malignant cells in gastrointestinal cancer. However, despite a high specificity, the sensitivity of traditional ascitic fluid cytology remains insufficient, at around 60%. Since 2004 the CellSearch ® technology has shown its advantages in the detection of circulating tumor cells (CTCs) in peripheral blood, which can perform an accurate diagnosis and molecular analysis at the same time. To our knowledge, no previous study has explored the potential utility of this technology for the detection and quantification of tumor cells in ascitic fluid samples. Herein we report a case of metastatic esophageal adenocarcinoma in a 70-year-old man presenting with dysphagia and a large amount of fluid in the peritoneal cavity. Analysis of a peripheral blood sample and ascites sample with the CellSearch ® technology both revealed the presence of putative tumor cells that were positive for epithelial cell adhesion molecule (EpCAM) and cytokeratin (CK) expression. This study confirmed the hematogenous dissemination of esophageal cancer by the detection of circulating tumor cells in the peripheral blood, and is the first to demonstrate that tumor cells can be identified in ascitic fluid by using CellSearch ® technology.

Detection of circulating tumor cells in patients with esophagogastric or pancreatic adenocarcinoma using the CellSearch® system: An observational feasibility study

“…Thus far, the detection of CTCs in the circulation of patients with AEGJ has been based on anecdotal findings and case reports (15). A recent study reported the successful detection of CTCs (≥2 CTCs/7.5 ml of blood) in 8 out of 18 patients (44.4%) with gastric or esophageal cancer (16), which could not be confirmed by the present small series.…”

“…However, as there is only limited literature available regarding the use of CellSearch ® in patients with esophagogastric or pancreatic cancer (15)(16)(17)(18), the present study aimed to determine whether CTCs are detectable by the CellSearch ® system in these particular patient groups. AEGJ and pancreatic cancer were chosen due to their epithelial cell characteristic, an increasing incidence in the Western world and the rather high mortality even after surgical and/or chemotherapeutic treatments.…”